HomeMy WebLinkAboutE-05-1220 Irrigation Well A Electrical Permits•
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Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No. CC _ ��Z,U�y
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 4 �•yy
[Rev. 11/991 leave blank
TLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
IN INK OR TYPE ALL INFORMATION) Date: 6/28/05
Oh City r Town of: Yarmouth To the Inspector of Wires:
applicatio the undersigned gives notice of his or her intention to perform the electrical work described below.
'JSt t & Number) 121 Camp Street, Irregation Well A
o enant Gatewood Homes Inc. Telephone No.
s Address 1600 Falmouth Road 925 Centerville, NIA02632
permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box)
Purpose of Building
Existing Service Amps /
New Service 100 Amps 120/240
Number of Feeders and Ampacity 2/100
Utility Authorization No. 1457675
Volts Overhead ❑ Undgrd ❑
Volts Overhead ❑ Undgrd X
No. of Meters
No. of Meters 1
Location and Nature of Proposed Electrical Work: Install meter main type service, 100 ampere type, underground type,
installed on pedestal
Completion ofthe following table may be waived by the Inspector of Wires.
No. of Recessed Fixtures
No. of Ceil: Susp. (Paddle) Fans
No. o Total
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
Generators KVA
No. of Lighting Fixtures
g g
Swimming Pool Above ❑ In- ❑
g rnd. rnd.
o. o Units cy Lighting
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
D and
No. o Initiating Devices
No. of Ranges
No. of Air Cond. Total Tons
No. of Alerting Devices
No. of Waste Dis osers
p
eat Pump
Totals:
Number
Tons .
....... . ......
o. oSelf-Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Co n El Other
Conneectiocho n
No. of Dryers
�'y
Heating Appliances KW
Security Systems:
No. of Devices or Equivalent
No. of Water KW
Heaters
No. of No. of
Signs Ballasts
Data Wiring:
No. of Devices or E uivalent
No. H dromassa a Bathtubs
y g
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or E uivalent
OTHER: Irrigation well valve opener and convenience outlet.
Attach additional detail if desired, or as required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE X BOND ❑ OTHER ❑ (Specify:)
Estimated Value of Electrical Work: (When required by municipal policy.)
10/31/2005
(Expiration Date)
Work to Start: Inspections to be requested in accordance with NEC Rule 10, and upon completion.
I certify, under the pains and penalties of perjury, that the information on this application is true and complete
FIRM NAME: PATTON ELECTRIC, INC. LIC. NO.: A 15542
Licensee: RICHARD PATTON Signature LIC. NO.:
(If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 508-539-0200
Address: PO BOX 1525 MASHPEE MA 02649 Alt. Tel. No.: 774-353-6878
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below, I hereby waive this requirement. I am the (check one) 0 owner ❑ owner's a ent.
Owner/Agent PERMIT FEE: $ 50.00
Signature Telephone No.